Being a mom of two boys born prematurely, this topic hits more closely home. A premature infant is defined as a baby born before 37 weeks. The earlier the birth occurred, the likelihood that more short term and long term complications may develop. Every family who has gone through a premature birth has their own story, with unique circumstances specific to their situation. Some babies, like my boys, miraculously have no NICU stay and go home with their families. For them, challenges from prematurity begin at home. Others begin their challenges in the NICU and then transition the learning to home.
Occupational therapists can play an important role in a baby’s development during their stay at the hospital and after transitioning home through the early intervention system. These little ones have occupations too! Their main occupations include sleeping, feeding, and interaction. These occupations are met through the various intertwining developmental components addressed through therapy including neurobehavioral organization (brain and muscles working together), sensory development, feeding, and social-emotional development.
Neurobehavioral: Occupational therapists may assist with positioning in isolette, crib, etc. They are instrumental in educating families on positioning infants while being held; this includes for comfort, feeding, and burping. Occupational therapists may also work with the team to form splints to help manage tone and range of motion.
Sensory: These fragile babies need protection from excessive input from the environment. Occupational therapists help the infant and family understand how to best organize and regulate stimuli that is coming in from the environment, whether from sound, light, or touch.
Feeding: Premature infants are fed by breast, bottle, or through a NG tube or G tube. If tube fed, oral stimulation and caregiver education are the primary goals. Feeding encompasses making sure the baby is getting enough nutrients for weight gain and growth to working on the skills required for feeding such as coordinating the suck- swallow-breath reflex as well as considering all the environmental factors that play a role in optimal feedings. Some families will also work closely with a Nutritionist and GI doctor as part of their team.
Social-Emotional: Interaction is an important piece for these infants. Some may only be able to use their eyes to explore if limited in the NICU. Others may gain more social connection while being held or during bath time.
Families need to maintain awareness of the developmental milestones throughout their baby’s growth. There are many resources on prematurity. The March of Dimes is a nice resource on prematurity as they are advocates for healthy pregnancy and have a Prematurity Campaign. Every year, the March of Dimes comes out with a report card rating for the rate of prematurity in the U.S. This year, our country has received a “C” grade with a 9.6% rate of prematurity in America currently.